OhioHealth has launched an effort to improve healthcare access for their homeless population with a care model that is getting more attention from hospitals as they seek to mitigate some of the financial impact of the COVID-19 pandemic.
The Columbus-based health system announced Monday the opening of the Medical Respite at Faith Mission, a 3,000 square foot, 16-bed facility that will be open 24 hours a day to provide homeless patients a place to continue their recovery for up to 45 days after they are discharged from an OhioHealth hospital.
OhioHealth's philanthropic arm, the OhioHealth Foundation, donated $350,000 to start up Faith Mission and will cover up to 14 days of medication costs for patients if needed. The daily operation of the program will be conducted by local social services network Lutheran Social Services, which has partnered with OhioHealth on the initiative.
Talks of starting a medical respite program began around four years ago, according to Jacqui Bastian, director of care management at OhioHealth's Grant Medical Center, as the hospital began seeing an increase in homeless patients. The rate of homelessness in Franklin County increased 6.4% from 2017 to 2018.
Projections indicate an impending housing crisis due to COVID-19, as business closures and job losses cause a sharp spike in evictions and foreclosures. An August analysis from policy think tank Aspen Institute estimated up to 40 million people could be at risk of eviction over the next several months.
Bastian said the pandemic has only highlighted the need for medical respite care.
"We're now really in the middle of the worst part of the pandemic," Bastian said. "It's kind of ironic that this is when we opened."
As the system began caring for more homeless patients, frustration started to grow over the problem of where to send them after their acute care needs have been met.
"We ended up keeping patients sometimes eight weeks or longer if they were getting IV antibiotic therapy," Bastian said. "What ends up happening is that you have a situation where patients who really need an acute-care bed cannot get in sometimes and then ED [emergency department] stacks up and it just causes a back log."
But simply discharging homeless patients was also not an option. Bastian said many area shelters would not take in patients that came directly from the hospital because they had ongoing care needs, while discharging them back onto the street resulted in many coming back to ED once their conditions worsened.
Under the new program homeless patients can be discharged directly to Faith Mission, which will be staffed by a nurse manager and a medical assistant, with nearby access to physicians and clinical staff working in an adjacent federally qualified health center run by Lutheran Social Services.
"There is a real need in our community for a medical respite for people experiencing homeless," said Sue Villilo, assistant vice president of community-based services at LSS in a written statement. "Not only is it a more cost-effective solution, but it's a more appropriate and comfortable environment for people recovering from illness or surgery who are also facing the additional crisis of being homeless."
The number of medical respite programs have grown in the U.S. in recent years from just 65 in 2014 to 115, according to figures from the National Health Care for the Homeless Council.
While the majority of such programs are still operated by philanthropic and social service organizations, more hospitals have shown interest in getting involved with medical respite in recent years as a means of saving on health costs. .
Barbara DiPietro, senior director of policy at the National Health Care for the Homeless Council, said the interest in medical respite among hospitals and healthcare more broadly has only accelerated since the start of the pandemic as revenue losses and mounting health costs have caused financial strain for many providers.
"As hospitals are getting by COVID they are really assessing what their capacity is inside in terms of the number of beds and level of care ," said Barbara DiPietro, senior director of policy at the National Health Care for the Homeless Council. "We're seeing medical respite respond in both protective housing for people at risk so that they don't pose additional threat and we also have programs that are providing some really good isolation and quarantine spaces for those who are COVID involved."Bastian said hospitals are just beginning to recognize the potential financial benefits of medical respite care. She said funding a program may cost around $200 per person compared to costing roughly $1,800 a day or more for an inpatient stay.
"It's really a win-win," Bastian said. "It's kind of like one of those no-brainers where why would we not want to have something that can provide support to our patients in our community."